nach oben

Sleep and Breathing

Erschienen in:

24.06.2021 | Sleep Breathing Physiology and Disorders • Original Article

The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study

verfasst von: Selin Çakmakcı, Aylin Özgen Alpaydın, Sevgi Özalevli, İbrahim Öztura, Bahriye Oya İtil

Erschienen in: Sleep and Breathing | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Obstructive sleep apnea (OSA) is an important public health problem. Beyond common treatment options, solution-oriented options are needed. Oropharyngeal exercise training may be a research area in this respect. This study aimed to evaluate the effects of oropharyngeal exercise (OPE) in addition to continuous positive airway pressure (CPAP) therapy in patients diagnosed with OSA.

Methods

Patients with moderate and severe OSA were screened from the electronic database of our hospital and 41 patients (20: exercise group; 21: control group) were included in the study. Each patient was assessed with CPAP usage time, maximal voluntary ventilation (MVV), maximum inspiratory and expiratory pressure (MIP-MEP), neck circumference, body mass index (BMI), waist-hip ratio, Epworth sleepiness score, Pittsburgh sleep quality index (PSQI), and short-form health survey (SF-36) in the first visit. The OPE was prescribed in addition to CPAP for the exercise group and performed by the patients for 3 months. At the end of the third month, groups were re-assessed with the same parameters.

Results

Most of the patients were men, and the mean age of the study population was 51.9 ± 7.4; the mean apnea–hypopnea index (AHI) in the last polysomnography report was 53.3 ± 27.4. In the exercise group, MVV (p = 0.003), MIP (p = 0.002), MEP (p = 0.024), and SF-36 energy/fatigue (p = 0.020) were observed to increase while the total PSQI score (p = 0.036) decreased. The neck circumference (p = 0.006) and BMI (p = 0.013) were found to be significantly decreased in the exercise group.

Conclusions

We found that OPE training may have improved respiratory muscle strength as well as sleep quality and health-related quality of life in the exercise group. OPE along with CPAP therapy may be recommended in moderate and severe OSA patients who are willing to participate.

Nur mit Berechtigung zugänglich

Lavie P, Lavie L (2008) Cardiovascular morbidity and mortality in obstructive sleep apnea. Curr Pharm Des 14(32):3466–3473. https://doi.org/10.2174/138161208786549317CrossRefPubMed

Kapur VK, Auckley DH, Chowdhuri S et al (2017) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 13(3):479–504. https://doi.org/10.5664/jcsm.6506CrossRefPubMedPubMedCentral

Patil SP, Ayappa IA, Caples SM, John Kimoff R, Patel SR, Harrod CG (2019) Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 15(2):335–343. https://doi.org/10.5664/jcsm.7640CrossRefPubMedPubMedCentral

Bloch KE (2006) Alternatives to CPAP in the treatment of the obstructive sleep apnea syndrome. Swiss Med Wkly. 136 17–18. 261 267 2006/17/smw-11158

Malhotra A, White DP (2002) Obstructive sleep apnoea. Lancet 360(9328):237–245. https://doi.org/10.1016/S0140-6736(02)09464-3CrossRefPubMed

Schwartz AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL (2008) Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc 5(2):185–192. https://doi.org/10.1513/pats.200708-137MGCrossRefPubMedPubMedCentral

Sforza E, Bacon W, Weiss T, Thibault A, Petiau C, Krieger J (2000) Upper airway collapsibility and cephalometric variables in patients with obstructive sleep apnea. Am J Respir Crit Care Med 161(2):347–352. https://doi.org/10.1164/ajrccm.161.2.9810091CrossRefPubMed

Davidson TM (2003) The great leap forward: the anatomic basis for the acquisition of speech and obstructive sleep apnea. Sleep Med 4(3):185–194. https://doi.org/10.1016/S1389-9457(02)00237-XCrossRefPubMed

Arens R, Marcus CL (2004) Pathophysiology of upper airway obstruction: a developmental perspective. Sleep 27(5):997–1019. https://doi.org/10.1093/sleep/27.5.997CrossRefPubMed

10.

Randerath WJ, Galetke W, Domanski U, Weitkunat R, Ruhle K-H (2004) Tongue-muscle training by intraoral electrical neurostimulation in patients with obstructive sleep apnea. Sleep 27(2):254–259. https://doi.org/10.1093/sleep/27.2.254CrossRefPubMed

11.

Guimarães KC, Drager LF, Genta PR, Marcondes BF, Lorenzi-Filhoy G (2009) Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. Am J Respir Crit Care Med 179(10):962–966. https://doi.org/10.1164/rccm.200806-981OCCrossRefPubMed

12.

Engleman HM, Wild MR (2003) Improving CPAP use by patients with the sleep apnoea/hypopnoea syndrome (SAHS). Sleep Med Rev 7:81–99CrossRef

13.

Sateia MJ (2014) International classification of sleep disorders-third edition. Chest 146(5):1387–1394. https://doi.org/10.1378/chest.14-0970CrossRefPubMed

14.

The AASM manual for the scoring of sleep and associated events. Rules, terminology and technical specifications. Version 2, 2012.

15.

Guimarães KCC PH. The phonoaudiological work at obstructive sleep apnea [abstract]. Sleep. 2003;26(A209.)

16.

Graham BL, Steenbruggen I, Miller MR, et al (2019) Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med;200(8):e70-e88 https://doi.org/10.1164/rccm.201908-1590ST

17.

ATS/ERS statement on respiratory muscle testing (2002) Am J Respir Crit Care Med 166(4):518–624. https://doi.org/10.1164/rccm.166.4.518CrossRef

18.

Miller MR (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338. https://doi.org/10.1183/09031936.05.00034805CrossRefPubMed

19.

Kevin Norton. Standards for anthropometry assessment. In: Kinanthropometry and exercise physiology. 4th ed. Routledge, London; :68–137.

20.

21.

Khosla T, Lowe CR (1967) Indices of obesity derived from body weight and height. J Epidemiol Community Heal 21(3):122–128. https://doi.org/10.1136/jech.21.3.122CrossRef

22.

Johns MW (1992) Reliability and factor analysis of the Epworth sleepiness scale. Sleep 15(4):376–381. https://doi.org/10.1093/sleep/15.4.376CrossRefPubMed

23.

Ağargün MY, Kara HAÖ (1996) The validity and reliability of the Pittsburgh sleep quality index. Published online, Turkish J Psychiatry

24.

Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care;30(6):473–483 http://www.ncbi.nlm.nih.gov/pubmed/1593914

25.

Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N MA. Reliability and validity of the Turkish version of short form-36 (SF-36). İlaç ve Tedavi Derg. 12:102–106.

26.

Aydemir Ö KE (2007) Psikiyatride Kullanılan Klinik Ölçekler. In: Psikiyatride Kullanılan Klinik Ölçekler. 3rd ed. Hekimler Yayın Birliği Basım Yayın:346–353. https://doi.org/10.18506/anemon.325977

27.

Ware JE (2000) SF-36 health survey update. Spine (Phila Pa 1976);25(24):3130–3139. doi:https://doi.org/10.1097/00007632-200012150-00008

28.

Camacho M, Certal V, Abdullatif J et al (2015) Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. Sleep 38(5):669–675. https://doi.org/10.5665/sleep.4652CrossRefPubMedPubMedCentral

29.

Atilgan E, Kunter E, Algun ZC (2020) Are oropharyngeal exercises effective in obstructive sleep apnea syndrome? J Back Musculoskelet Rehabil 33(2):209–216. https://doi.org/10.3233/BMR-171101CrossRefPubMed

30.

Ieto V, Kayamori F, Montes MI et al (2015) Effects of oropharyngeal exercises on snoring. Chest 148(3):683–691. https://doi.org/10.1378/chest.14-2953CrossRefPubMed

31.

Younis A. Hemmat Baz AAEM. Upper airway exercises in patients with obstructive sleep apnea. http://www2.mans.edu.eg/hospitals/muh/depts/sdbu/Research/Papers/ Upper.pdf

32.

Clark HM (2003) Neuromuscular treatments for speech and swallowing. Am J Speech-Language Pathol 12(4):400–415. https://doi.org/10.1044/1058-0360(2003/086)CrossRef

Titel: The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study
verfasst von: Selin Çakmakcı
Aylin Özgen Alpaydın
Sevgi Özalevli
İbrahim Öztura
Bahriye Oya İtil
Publikationsdatum: 24.06.2021
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 2/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02423-y

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

The effect of oropharyngeal exercise in patients with moderate and severe obstructive sleep apnea using CPAP: a randomized controlled study